Prevalence of overweight and obesity in The Netherlands in relation to sociodemographic variables, lifestyle and eating behavior: starting points for the prevention and treatment of obesity

The prevalence and incidence of overweight and obesity has been studied in a young adult population aged 19-35 years. Special attention was given to the relation with psychosociological variables and life-style. The prevalence of overweight and obesity was also studied in a representative population for The Netherlands, in which population also the relation with self-reported illness and subjective health was studied. In the patient population of four general practices the relation of overweight and obesity with disease was investigated in a retrospective design. Also the influence of the body fat distribution was studied. The prevalence of overweight (BMI greater than 25 kg/m2) in the Dutch adult population was 34% in men and 24% in women. The prevalence of obesity (BMI greater than 30 kg/m2) was 4 and 6% in men and women, respectively. The prevalence of overweight and obesity was negatively related with social class and increased with age. Also, life-style variables such as coffee consumption, alcohol consumption, smoking and amount of hours sleep (CASS behavior), physical activity during leisure time, slimming behavior and health-conscious behavior were correlated with the prevalence of overweight. Life events caused an increase in body weight, but in women (not in men) this gain was suppressed by following slimming periods. Thus, emotional eating seems to be an important factor in the etiology of obesity. The results of our studies on the relation of overweight and obesity with morbidity aspects show a clear relation of some diseases and subjective health with overweight, especially in men and women with an abdominal fat distribution. From the results of this study starting points for the prevention and treatment of obesity are proposed.     

Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988-1994

OBJECTIVE: To compare self-reported to measured heights and weights of adults examined in the Third National Health and Nutrition Examination Survey (NHANES III), and to determine to what extent body mass index (BMI) calculated from self-reported heights and weights affects estimates of overweight prevalence compared with BMI calculated from measured values. DESIGN: A complex sample design was used in NHANES III to obtain a nationally representative sample of the US civilian, noninstitutionalized population. During household interviews, survey respondents were asked their height and weight. Trained health technicians subsequently measured height and weight using standardized procedures and equipment. SUBJECTS: The analytical sample consisted of 7,772 men and 8,801 women 20 years old and older. STATISTICAL ANALYSES PERFORMED: Only persons with measured and self-reported heights and weights were included in the analysis, and statistical sampling weights were applied. t Tests, Pearson product moment correlation coefficients, sensitivity, and specificity analyses were used to determine the validity of self-reported measurements and prevalence estimates of overweight, defined as BMI of 25 or greater. RESULTS: Age is an important factor in classifying weight, height, BMI, and overweight from self-reports. Statistically significant differences were found for the mean error (measured-self-reported values) for height and BMI that were notably larger for older age groups. For example, the mean error for height ranged from 2.92 to 4.50 cm for women and from 3.06 to 4.29 cm for men, 70 years and older. Despite the high correlation between measured and self-reported data, the prevalence of overweight calculated from measured values was higher than that calculated from self-reported values among older adults. When calculated with self-reported height, BMI was one unit lower than when calculated from measured height for persons > or = 70 years. Specificity was high but sensitivity decreased with increasing age cohorts. Regression equations are provided to determine actual height from self-reported values for older adults. CONCLUSION/APPLICATIONS: Self-reported heights and weights can be used with younger adults, but they have limitations for older adults, ages > or = 60 years. In research studies and in clinical settings involving older adults, failure to measure height and weight can result in subsequent misclassification of overweight status. Therefore, registered dietitians are encouraged to obtained a measured weight and height using a calibrated scale and stadiometer.     

Peer Reviewed: Validity of Self-Reported Height,Weight, and Body Mass Index: Findings from the National Health and Nutrition Examination Survey, 2001-2006

Introduction

Our study extends previous studies that have evaluated the level of bias in self-reported height and weight and corresponding body mass index (BMI). Results are evaluated by age, sex, income, race/ethnicity, and BMI classifications.

Methods

Analyses are based on the National Health and Nutrition Examination Survey (NHANES) from 2001-2006. The sample was 8,208 men and 8,606 women aged 16 years or older.

Results

On average, men overreport their height by 1.22 cm (0.48 in) and their weight by 0.30 kg (0.66 lbs), and women overreport their height by 0.68 cm (0.27 in) and underreport their weight by −1.39 kg (−3.06 lbs). Overreporting of height significantly increases with age after age 50 for men and after age 60 for women. Overreporting of weight in men is significant in the age groups 16 to 49 years and 70 years or older. Women significantly underreport their weight in each age group but more so in the age group 16 to 49 years, followed by 50 to 69 years, and then 70 years or older. Men are more likely than women to think their weight is about right if they are at a normal weight or are overweight or obese, but women are more likely to think their weight is about right if they are underweight.

Conclusion

Men and women significantly overreport their height, increasingly so at older ages. Men tend to overestimate their weight, but women underreport their weight, more so in younger ages. Corresponding BMI is underestimated, more so for women than for men at each age and increasingly so with older age for both sexes.     

Bodyweight, gender, and quality of life: a population-based longitudinal study

Purpose

The objective of the paper is to describe trajectories of health-related quality of life (HRQL) associated with categories of body mass index (BMI): underweight, normal weight, overweight, obese class I, and obese classes II and III.

Methods

Data come from the longitudinal Canadian National Population Health Survey. Analyses are based on data for 3,864 men and 4,745 women who were 40+ in 1998/1999 and followed through 2006/2007. HRQL was measured with the Health Utilities Index Mark 3. Multi-level growth modeling was used.

Results

HRQL declined with age. For men, there was a large HRQL decrement for being underweight; trajectories for all other BMI categories were very similar. For women being underweight was associated with higher HRQL at younger ages but lower at older ages. Otherwise, for women, HRQL was ordered from highest to lowest: normal, overweight, obese class I, and obese classes II and III.

Conclusions

Given that excess weight is a risk factor for mortality and the development of chronic conditions, the HRQL results for men are surprising. The HRQL results for women may reflect both the importance of body image on mental health and the health effects of excess weight.     

A comprehensive examination of health conditions associated with obesity in older adults

BACKGROUND: Over 70% of older adults in the United States are overweight or obese. To examine the overall health burden of obesity in older adults, the Vitamins and Lifestyle cohort study of western Washington State recruited 73,003 adults aged 50 to 76 who completed a self-administered questionnaire on current height and weight, medical history, and risk factors. METHODS: Cross-sectional analysis of body mass index (BMI) and health conditions was performed using data collected in 2000 to 2002. Participants were categorized as normal weight, overweight, obese I, or obese II/III using BMI cut-points. Health conditions included 7 serious diseases, 2 conditions associated with cardiovascular disease risk, 23 medical conditions, and 11 health complaints. Odds ratios (ORs) from logistic regression models were used to examine associations of the four BMI categories with each health condition. Analyses were gender stratified and adjusted for age, education, race/ethnicity, and smoking status. RESULTS: Among women, 34% were overweight, 16% in the obese I category, and 10% in obese categories II/III. Among men, 49% were overweight, 18% in the obese I category, and 6% in obese categories II/III. Overall, 37 of 41 conditions examined for women and 29 of 41 conditions examined for men were associated with increased levels of BMI (trend p <0.05 for all models). For women and men, respectively, the highest ORs comparing obese II/III to normal weight were diabetes (OR=12.5 and 8.3), knee replacement (OR=11.7 and 6.1), and hypertension (OR=5.4 and 5.6). Obesity also increased the odds of several rare diseases such as pancreatitis (OR=1.9 and 1.5) and health complaints such as chronic fatigue (OR=3.7 and 3.5) and insomnia (OR=3.5 and 3.1). CONCLUSIONS: A broad range of diseases and health complaints are associated with obesity. Clinicians should be aware of the diverse ways in which being overweight or obese may affect the health of their patients when counseling them about weight loss.     

Frequency of attendance at religious services, overweight, and obesity in American women and men: the Third National Health and Nutrition Examination Survey

PURPOSE: Few data have been published on the association of overweight and obesity and indices of religiousness, a putative protective factor for cardiovascular morbidity and mortality, in representative samples of multiethnic total populations. METHODS: To test the hypothesis that frequency of attendance at religious services is unrelated to the prevalence of overweight and obesity, the following data from American men and women aged 20 years and older (N = 16,657) in a cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey, were analyzed: self-reported frequency of attendance at religious services, cigarette smoking, health status, sociodemographic variables, and measured body mass index (BMI). RESULTS: In persons 20 years and older, 58% of frequent attenders (> or = 52 times/y) and 53% of others were overweight or obese (BMI > or = 25 kg/m2). After stratifying to eliminate interactions in a logistic regression model and controlling for sociodemographics, smoking, and health status, no significant association was seen in European-American women overall. In all others, the significant positive associations of frequency of attendance and overweight could be explained by these other variables (fully adjusted odds ratio, 1.16; 95% confidence interval, 0.98-1.36; p = 0.08). The same was true for obesity (BMI > or = 30 kg/m2). CONCLUSION: In a national sample of the US population, the prevalence of overweight or obesity is greater in self-reported frequent attenders of religious services than in others, but the association was explained by controlling for multiple sociodemographic and health variables.     

Effects of Age on Validity of Self-Reported Height, Weight, and Body Mass Index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994

Objective To compare self-reported to measured heights and weights of adults examined in the Third National Health and Nutrition Examination Survey (NHANES III), and to determine to what extent body mass index (BMI) calculated from self-reported heights and weights affects estimates of overweight prevalence compared with BMI calculated from measured values.Design A complex sample design was used in NHANES III to obtain a nationally representative sample of the US civilian, noninstitutionalized population. During household interviews, survey respondents were asked their height and weight. Trained health technicians subsequently measured height and weight using standardized procedures and equipment.Subjects The analytical sample consisted of 7,772 men and 8,801 women 20 years old and older.Statistical analyses performed Only persons with measured and self-reported heights and weights were included in the analysis, and statistical sampling weights were applied, t Tests, Pearson product moment correlation coefficients, sensitivity, and specificity analyses were used to determine the validity of self-reported measurements and prevalence estimates of overweight, defined as BMI of 25 or greater.Results Age is an important factor in classifying weight, height, BMI, and overweight from self-reports. Statistically significant differences were found for the mean error (measured-self-reported values) for height and BMI that were notably larger for older age groups. For example, the mean error for height ranged from 2.92 to 4.50 cm for women and from 3.06 to 4.29 cm for men, 70 years and older. Despite the high correlation between measured and self-reported data, the prevalence of overweight calculated from measured values was higher than that calculated from self-reported values among older adults. When calculated with self-reported height, BMI was one unit lower than when calculated from measured height for persons >70 years. Specificity was high but sensitivity decreased with increasing age cohorts. Regression equations are provided to determine actual height from self-reported values for older adults.Conclusion/Applications Self-reported heights and weights can be used with younger adults, but they have limitations for older adults, ages >60 years. In research studies and in clinical settings involving older adults, failure to measure height and weight can result in subsequent misclassification of overweight status. Therefore, registered dietitians are encouraged to obtained a measured weight and height using a calibrated scale and stadiometer. J Am DietAssoc. 2001;101:28-34.     

Are sexual dissatisfaction and sexual abuse associated with obesity? A population-based study

OBJECTIVE: To investigate whether there is any association between obesity and sexual satisfaction and sexual abuse in a normal population. RESEARCH METHODS AND PROCEDURES: A representative sample of 2810 subjects from a population study was interviewed about sexual satisfaction, sexual abuse, and life satisfaction. The answers from normal weight, overweight, and obese participants were compared. Univariate and multivariate analyses were performed. RESULTS: Data were presented separately for two age groups, 18 to 49 and 50 to 74 years, and gender. The older group of obese men reported a greater decrease of sexual desire compared with 5 years prior than normal weight men [odds ratios (OR), 2.44; 95% confidence interval (CI), 1.4 to 4.3]. The older group of overweight men reported involuntary participation in sexual activities more often than normal weight men (OR, 2.06; 95% CI, 1.1 to 3.8). Although older overweight and obese women were diagnosed with a lingering disease (defined as >1 month) more often than normal weight women (overweight: OR, 2.41; 95% CI, 1.3 to 4.4; obese: OR, 4.45; 95% CI, 1.7 to 11.5), there was no difference between BMI groups in satisfaction with physical health. DISCUSSION: Overweight and obese groups seem to be heterogeneous with respect to sexual satisfaction and experiences of sexual abuse. No significant differences were detected between BMI groups, which does not exclude the possibility of significant differences between BMI groups among patients seeking medical attention.     

Body mass index in adolescence and number of children in adulthood

BACKGROUND: Body weight is associated with reproduction and related behaviors, but it is unknown whether it has significance for fertility differences in the general population. We examined whether adolescent body mass index (BMI; kg/m) predicted the number of children in adulthood 21 years later. METHODS: The participants were 1298 Finnish women and men (ages 12, 15, and 18 years at baseline) followed in a prospective population-based cohort study (the Cardiovascular Risk in Young Finns) from year 1980 to 2001. RESULTS: There was an inverted J-shaped association between BMI and the number of children, such that underweight adolescents had 10-16% fewer children in adulthood, overweight adolescents 4-8% fewer, and obese adolescents 32-38% fewer than individuals with normal adolescent weight. This association was similar in women and men, and independent of age, education, urbanicity of residence, and timing of menarche (in women). Adolescents with low or high BMI were less likely to have lived with a partner in adulthood, which partly accounted for their decreased number of children. The influence of adolescent BMI was independent of adulthood BMI in women but not in men. Age at menarche also predicted the number of children, such that women with early or late menarche had more children than those with average age at menarche. CONCLUSION: Underweight and especially obesity may have a negative impact on fertility in the general population. The increasing prevalence of obesity in children and adolescents may represent a concern for future reproductive health.     

Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age

Computed tomography scans at the level of L4/L5 were analysed in 66 men and 34 women who presented for routine tomography, stratified into different age categories. Areas of intra-abdominal fat and subcutaneous abdominal fat were calculated from the scans. In men and in women the proportion of the body surface as intra-abdominal fat increased with age (in men from 12.4 per cent in the age group less than 40 years to 18.0 per cent in the age group greater than 65 years; in women from 10.5 per cent to 14.7 per cent in the respective age categories). Only in men this increase with age was independent of the degree of obesity. In women younger than 40 years the proportion of intra-abdominal fat did not increase with increasing BMI while it did in older women and men. The proportion of intra-abdominal fat in 7 adolescents appeared to be 5.4 per cent, considerably lower compared to adult men and women. Subcutaneous fat areas increased with the degree of obesity but not with age. From simple anthropometric measurements, the intra-abdominal fat area was best correlated with the waist circumference in all ages (except for women younger than 40 years) while it showed weaker associations with abdominal skinfolds and circumference ratios. Age and BMI explained 68 and 74 per cent of the variance in intra-abdominal fat area in men and women respectively. Waist added 8 per cent to the explained variance in men but nothing in women. BMI and waist circumference showed similar correlations to total, intra-abdominal and subcutaneous fat areas in all age categories whereas correlations of skinfolds with intra-abdominal fat areas decreased with age.     

Body mass index and nutritional status of adult Savar tribals of Keonjhar District, Orissa, India

A cross-sectional study was undertaken to determine sex differences in mean body mass index (BMI) and nutritional status (based on BMI), as well as the effect of age on BMI and nutritional status of adult Savars, a tribal population of Orissa, India. A total of 600 adult (aged > 18 years) Savars of four villages, namely, Bonianiposi, Morabali, Panchapolli and Sailong of Keonjhar District, Orissa, India, were studied. Height and weight were measured and BMI computed. Mean ages of both sexes were similar (men: mean = 38.9 years, sd = 15.3; women: mean = 38.0, sd = 13.9). Men had significantly greater mean height (p < 0.001), weight (p < 0.001) and BMI (p < 0.05). The prevalence (sex combined) of undernutrition (BMI < 18.5) was found to be very high (43.5%). Moreover, there was a significant (chi2 = 7.39, p = 0.025) difference in the prevalence of undernutrition between men (38%) and women (49%). Age was significantly (p < 0.001) negatively correlated with BMI in both sexes (men: r = -0.20; women: r = -0.16). In general, the frequency of undernutrition increased with increasing age. In conclusion, this study demonstrated that the prevalence of adult undernutrition was very high among Savar women and high among Savar men. These rates increased with increasing age. Therefore, from the public health point of view, immediate nutritional intervention programmes are needed for implementation among Savars, especially among older individuals. Moreover, further research is needed not only among this ethnic group but also other tribal populations of India to fully understand the causes and consequences of adult undernutrition.     

Body mass index and the prevalence of hypertension and dyslipidemia

OBJECTIVE: To describe and evaluate relationships between body mass index (BMI) and blood pressure, cholesterol, high-density lipoprotein-cholesterol (HDL-C), and hypertension and dyslipidemia. RESEARCH METHODS AND PROCEDURES: A national survey of adults in the United States that included measurement of height, weight, blood pressure, and lipids (National Health and Nutrition Examination Survey III 1988-1994). Crude age-adjusted, age-specific means and proportions, and multivariate odds ratios that quantify the association between hypertension or dyslipidemia and BMI, controlling for race/ethnicity, education, and smoking habits are presented. RESULTS: More than one-half of the adult population is overweight (BMI of 25 to 29.9) or obese (BMI of > or =30). The prevalence of high blood pressure and mean levels of systolic and diastolic blood pressure increased as BMI increased at ages younger than 60 years. The prevalence of high blood cholesterol and mean levels of cholesterol were higher at BMI levels over 25 rather than below 25 but did not increase consistently with increasing BMI above 25. Rates of low HDL-C increased and mean levels of HDL-C decreased as levels of BMI increased. The associations of BMI with high blood pressure and abnormal lipids were statistically significant after controlling for age, race or ethnicity, education, and smoking; odds ratios were highest at ages 20 to 39 but most trends were apparent at older ages. Within BMI categories, hypertension was more prevalent and HDL-C levels were higher in black than white or Mexican American men and women. DISCUSSION: These data quantify the strong associations of BMI with hypertension and abnormal lipids. They are consistent with the national emphasis on prevention and control of overweight and obesity and indicate that blood pressure and cholesterol measurement and control are especially important for overweight and obese people.     

Overweight and all-cause mortality in a Swedish rural population: Skaraborg Hypertension and Diabetes Project

AIMS: To explore the prevalence of overweight in men and women in a Swedish rural community and to examine its associations with all-cause mortality. METHODS: A community-based cohort study. A total of 1,109 men and women aged >or= 40 years participated in a survey of cardiovascular disease (CVD) risk factors in the city of Skara in Skaraborg, Sweden, in 1993-94. Overweight was defined as a BMI >or=25.0 kg m(-2). Vital status was ascertained to 31 December 1999 and sex-specific associations between overweight and mortality were explored. RESULTS: The prevalence of overweight according to the WHO's criteria exceeded 50% in men and 35% in women. In men there was an inverse association between BMI and mortality. Men in the lowest quartile of BMI experienced the highest mortality with 44.1 deaths per 1,000 person-years. The hazard ratio (HR) in the highest quartile was 0.6 (95% CI 0.4-0.9). In women there were no significant differences in mortality between quartiles of BMI. In both men and women with previous CVD the mortality rates decreased with quartiles of increasing BMI. The inverse association between BMI and mortality was confined to elderly men with a history of CVD. CONCLUSION: In both sexes the association between BMI and mortality differed across subgroups of age and of a history of previous CVD. No indication of overweight being negative for longevity was found in this population. Higher age and a history of previous CVD contribute to the excess mortality seen in subjects with low BMI.     

Increasing prevalence of overweight, obesity and physical inactivity: two population-based studies 1986 and 1994

INTRODUCTION: The aim of this study was to investigate the 1986-1994 trend in obesity, overweight and sedentary leisure-time physical activity status, and the educational gradient in overweight and obesity in the city of Malm?, Sweden. MATERIAL/METHODS: The public health surveys in Malm? 1986 and 1994 are cross-sectional studies. A total of 4,800 and 5,600 individuals aged 20-80 years were randomly chosen to be interviewed by a postal questionnaire. The participation rates were 74% and 71%. Obesity was defined as BMI 30.0 or more and overweight as BMI 25.0-29.9. The prevalences of leisure-time physical inactivity, obesity and overweight were computed, and the differences between 1986 and 1994 as well as educational gradients in overweight and obesity were assessed. RESULTS: The prevalence of obesity increased from 4.6% to 11.4% (p<0.001) among men and from 6.1% to 9.8% (p<0.001) among women. The prevalence of overweight (BMI 25.0-29.9) increased from 33.9% to 45.2% (p<0.001) among men, and from 19.6% to 29.1% (p<0.001) among women. The prevalence of leisure time physical inactivity increased among men from 14.7% to 18.1% (p<0.001) among men and from 19.4% to 26.7% (p<0.001) among women. The increasing prevalences of obesity, overweight and physical inactivity were observed in all age, country of origin and educational status groups. The educational differences in BMI 25.0+ observed among both men and women in 1986 disappeared among men in 1994. In contrast, educational differences in obesity (BMI 30.0+), not seen in 1986, appeared in 1994 among men. CONCLUSION: The proportions of the population with obesity and overweight increased significantly between 1986 and 1994 for both men and women. The increasing prevalence of physical inactivity seems to be an important explanation.     

Occupational sitting time and overweight and obesity in Australian workers

BACKGROUND: One of the major immediate and long-term health issues in modern society is the problem of overweight and obesity. This paper examines the role of the workplace in the problem by studying the association between occupational sitting time and overweight and obesity (body mass index [BMI] > or =25) in a sample of adult Australians in full-time employment. METHODS: Data on age, gender, occupation, physical activity, occupational sitting time, and BMI were collected in September 2003 from a sample of 1579 adult men and women in full-time employment at the time of the survey. Logistic regression was used to examine the association between occupational sitting time and overweight and obesity. RESULTS: Mean occupational sitting time was >3 hours/day, and significantly higher in men (209 minutes) than in women (189 minutes, p=0.026). Univariate analyses showed significant associations between occupational sitting time and BMI of > or =25 in men but not in women. After adjusting for age, occupation, and physical activity, the odds ratio for BMI > or =25 was 1.92 (confidence interval: 1.17-3.17) in men who reported sitting for >6 hours/day, compared with those who sat for <45 minutes/day. CONCLUSIONS: Occupational sitting time was independently associated with overweight and obesity in men who were in full-time paid work. These results suggest that the workplace may play an important role in the growing problem of overweight and obesity. Further research is needed to clearly understand the association between sitting time at work and overweight and obesity in women.     

Obesity in adults: an emerging problem in urban areas of Ho Chi Minh City, Vietnam

OBJECTIVE: To assess the prevalence of overweight, obesity and underweight among Vietnamese adults living in urban areas of Ho Chi Minh City (HCMC), Vietnam. DESIGN: This cross-sectional survey was conducted in the local health stations of 30 randomly selected wards, which represent all 13 urban districts of HCMC, over a period of 2 months from March to April 2004. SUBJECTS: A total of 1488 participants aged 20-60 years completed the interview, physical examination and venous blood collection. MEASUREMENTS: Anthropometric measurements of body weight, height, waist and hip circumference were taken to construct indicators of adiposity including body mass index (BMI), waist circumference, and waist-to-height and waist-to-hip ratios. Both systolic and diastolic blood pressure and biochemical indicators of cardiovascular disease and type II diabetes risk (lipid profile and fasting blood glucose) were also measured. RESULTS: The age and sex standardized prevalence of overweight and obesity using Asian specific BMI cutoffs of 23.0 and 27.5 kg/m2 was 26.2 and 6.4%, respectively. The prevalence of overweight and obesity was slightly higher in females (33.6%) than males (31.6%), and progressively increased with age. The age and sex-standardized prevalence of underweight (BMI <18.5 kg/m2) among Vietnamese adults living in HCMC was 20.4%. The prevalence was slightly higher in males (22.0%) than in females (18.9%), and there was a much higher prevalence in all underweight categories in younger women than in men but this was reversed for older men. CONCLUSION: The adult population in HCMC Vietnam is in an early 'nutrition transition' with approximately equal prevalence of low and high BMI. The prevalence of overweight and obesity of Vietnamese urban adults was lower than that reported for other east and southeast Asian countries.     

Examining overweight and obesity as risk factors for common mental disorders using fat mass and obesity-associated (FTO) genotype-instrumented analysis: The Whitehall II Study, 1985-2004

The Mendelian randomization approach exploits genetic variants to improve causal inference when using observational data. The authors examined the relation between long-term obesity and common mental disorders (CMD) by utilizing the known relation between fat mass and obesity-associated (FTO) genotype and body mass index (BMI; weight (kg)/height (m)(2)). Data collection in 2,981 men and 1,164 women (mean age at baseline = 44 years) from the Whitehall II Study (London, United Kingdom) included 4 repeated examinations of BMI and CMD over a 19-year follow-up period (1985-2004), plus an assessment of FTO polymorphism rs1421085. In men, there was an association of FTO genotype with all measures of adiposity (mean BMI, number of times obese, and, in nonobese persons, number of times overweight). FTO was also associated with CMD in men. This was independent of adiposity, thus potentially violating the exclusion restriction assumption. According to both conventional and FTO-instrumented regression analysis, measurement of obesity was associated with an increased occurrence of CMD. In the FTO-instrumented analysis only, higher BMI and overweight were also associated with CMD. In women, there was no link between FTO and adiposity. Mendelian randomization analyses supported the status of long-term obesity as a risk factor for CMD in men-a finding that should be interpreted cautiously because the function of the FTO gene is unknown.     

Covariates of maternal overweight and obesity and the risk of adverse pregnancy outcomes: findings from a nationwide cross sectional survey

Background/Objectives

India is currently witnessing a rapid growth in obesity epidemic. We examined the covariates of overweight and obesity and the association between overweight and obesity and adverse pregnancy outcomes among adult married women in northern India.

Subjects/Methods

The analysis is based on 5,273 ever-married women of reproductive age (15–49) in the states of Delhi and Punjab, included in India’s second National Family Health Survey (NFHS-2), conducted in 1998–1999. Body mass index (BMI) was used to define the terms overweight (25?≤?BMI?<?30?kg/m²) and obesity (BMI?≥?30.0?kg/m²). Adverse pregnancy outcome was defined as a miscarriage or stillbirth. Binary and multinomial logistic regression methods were used to estimate the effects of the covariates ofn overweight and obesity and effects of overweight and obesity on adverse pregnancy outcomes.

Results

Age, urban residence, media habits, anemia status, and economic living standard are most important covariates of overweight and obesity among women in India. A separate analysis by women’s age finds that media habits and living standard are more important covariates for older women (30–49), whereas place of residence and education are more important covariates for younger women (15–29). The study also finds that overweight and obese women age 15–29 are significantly more likely to have experienced adverse pregnancy outcome (miscarriage or a stillbirth) in their lifetime. This relationship is not observed among older women.

Conclusions

The results are useful in identifying population groups for public health campaigns to promote appropriate diets and effective lifestyles to prevent the obesity epidemic and associated adverse pregnancy outcomes.     

Gender differences in the association of age with physical workload and functioning

Aims: To test whether (1) physically demanding work is less frequent for older than younger employees, and whether (2) the association of physically demanding work with decline of physical functioning is stronger for older employees than their younger counterparts. The gender differences in these associations were examined.

Methods: Subjects of the study were 40–60 year old employees of the City of Helsinki. Data (n = 5802) were collected with mail questionnaires in 2000 and 2001. Functioning was measured with the Role Limitations due to Physical Health Problems scale of the SF36 health questionnaire. Logistic regression models were used to analyse the data.

Results: There was a linear trend of less physically demanding work in older than in younger age groups. This trend was more marked for men than women. Age and physically demanding work were associated with poor functioning. In women the association of physically demanding work with poor functioning tended to be stronger for older than for younger age groups, while the opposite was observed in men.

Conclusions: Results suggest that physically demanding work causes more ailments in women of high age than men. It is possible that less men than women are still employed in physically demanding occupations at high age, even though direct evidence of exit from physically demanding work cannot be obtained from cross-sectional data. In these data the physically demanding occupations for men and women were largely different. High physical workload among women working in social and health care is likely to contribute to the gender differences.

     

The association between body mass index and health-related quality of life: data from CaM<Emphasis Type="Italic">os</Emphasis>, a stratified population study

BACKGROUND: Deviation from normal weight is associated with health risks, but less is known about the association between weight and health-related quality of life (HRQOL). We investigated this in the context of a population-based study, using a standard five-category weight classification system based on body mass index (BMI). METHODS: The Canadian Multicentre Osteoporosis Study is a randomly selected sample of men and women over 25 years of age from nine centres across Canada. Data were obtained by interview, and height and weight were measured and used to calculate BMI. HRQOL was measured using the SF-36. Multivariable linear regression was used to identify the association between BMI category and SF-36 scores after controlling for potential confounders. RESULTS: Complete data were available for 6,302 women and 2,792 men. Mean BMI for every age and gender group exceeded healthy weight guidelines. For women, being underweight, overweight or obese was associated with poorer HRQOL in most SF-36 outcomes while for men, this was associated with poorer HRQOL in some domains and with higher HRQOL in others. CONCLUSIONS: A significant proportion of the population may be putting their health at risk due to excess weight, which may have a substantial negative effect on HRQOL, particularly in women. This underscores the need for continued public health efforts aimed at combating overweight and obesity.